Duke University School of Nursing, 311 Trent Drive, Box 3322 DUMC, Durham, NC 27710, USA.
Nurse Educ Pract. 2010 Jul;10(4):243-8. doi: 10.1016/j.nepr.2009.11.013. Epub 2010 Jan 25.
Clinical practice guidelines have been developed to improve patient care and outcomes. Guideline implementation is often stymied by the complexity of patients' conditions, complex care environments, and limited advanced clinical training of nursing staff. To translate key elements of heart failure guidelines into practice in a nursing home, the Connected Learning Model was developed based on the diffusion of innovations framework. An advanced practice nurse in geriatrics fostered greater interaction and collaboration among key administrative, medical, and nursing staff to promote awareness of heart failure guidelines and to translate key practices from those guidelines into the nursing home setting. Direct care staff skills for early recognition and reporting of signs and symptoms of acute heart failure were enhanced through a learner-centered educational program which included classroom and unit-based instruction and bedside clinical teaching. The Connected Learning Model is a promising method to mobilize advanced nursing expertise to bridge research/practice gaps through implementation of clinical practice guidelines that are systematically adapted to accommodate diverse health care contexts.
临床实践指南的制定是为了改善患者的护理和结局。指南的实施常常受到患者病情的复杂性、复杂的护理环境以及护理人员临床高级培训的限制。为了将心力衰竭指南的关键要素转化为养老院的实践，根据创新扩散框架开发了连通学习模型。老年病学的高级实践护士促进了主要行政、医疗和护理人员之间的更多互动和协作，以提高对心力衰竭指南的认识，并将这些指南中的关键实践转化为养老院环境。通过以学习者为中心的教育计划，包括课堂和单元教学以及床边临床教学，提高了直接护理人员对急性心力衰竭体征和症状的早期识别和报告技能。连通学习模型是一种有前途的方法，可以通过实施临床实践指南来调动高级护理专业知识，这些指南经过系统调整以适应不同的医疗保健环境，从而弥合研究/实践差距。
